Diagnosing an AVM
Image of an AVM
Diagnosing an AVM includes a thorough physical examination with patient history. Some factors Dr. Yakes and the staff at Swedish Medical Center’s Vascular Malformation Center will take into consideration are initial symptoms at the time of occurrence and whether it was present at birth, whether there were hormonal influences, and whether the patient has had a Nicoladoni-Branham test (whether the patient's heart rate has slowed as a result of AVM compression). Patients will also undergo MRI and Color Doppler Imaging (CDI) as part of the AVM assessment in all anatomic locations. Dr. Yakes will look to distinguish between high-flow and low-flow AVM.
Ethyl Alcohol Injections to Treat AVM
Dr. Yakes will then begin a series of ethyl alcohol injections over a period of time determined by the anatomic location and severity of the AVM. The injections are done under general anesthesia in the operating room. In selected cases, additional Swan-Ganz line monitoring and arterial line may be necessary. The medical staff monitors pulmonary artery pressures during the injection as well.
"Usually patients experience a dramatic improvement because they are no longer suffering from that which has been harming them since they were born. We can affect a cure and allow people go on with their normal lives." - Wayne Yakes, M.D., Swedish Medical Center, Denver
Upon completion of the injections, the patient is brought to a post-operative recovery area. Most of the time, patients return home that day after the anesthesia wears off. In cases where the AVM is in serious proximity to a vitally functioning area of the body, an overnight stay may be required to monitor the patient’s vital signs. Any residual pain is managed with medication and some patients choose to stay home from school or work an additional day. Read about patients who have experienced success with treatment from the Swedish Vascular Malformation Center.